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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
ACN
DATE
FILE NO. 21 05 0'-\50
05109790
03-10-2005
lEV-1545 EllAFP t09-n).
~ .-r,,-
U',_
TYPE OF ACCOUNT
D SAVINGS
!Xl CHECKING
D TRUST
D CERTIF.
ES'l':OF ESTHER P WITMER
zaGS m,l 17 r'~~~ ~~. DEAT~94~~~~~~~~04
COUNTY CUMBERLAND
GERALD G WITMER
420 LIMESTONE RD
CARLISLE PA 17013
CLEF'~<
OR~'"''''
1""'I*1.h:'''; ~)
REHIT PAYHENT AND FDRHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent~ you were a joint owner/beneficiary of
this account. If you feel this inforllation is incorrect~ please obtain written correction frail the financial institution~ attach a copy
to this forM and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COMMonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU~TION5
Account No. 148068-11 Oat. 12-12-1994
Established
x
2,162.41
50.000
1, 081. 21
.045
48.65
To insure proper credit to your account~ two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills~ Agent",
Account Balance
Percent Taxable
A.ount Subject to
Tax Rate
Potential Tax Due
x
NOTE: If tax payMents are made within three
(3) months of the decedent's date of death~
you May deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART TAXPAYER RESPONSE
[!]1I:~j~~.~ij~i!i!"!ijjl~~~!i!j!..~jijij~l!ij!~!jiji.i~1~n!i!i!t.!!!i_~1lf:!i!jl.~I!j!i~ii!i.~I!I!!j.I~.jji!jl
A. IV'f The above inforllation and tax due is correct.
~ 1. You May choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ or you !lay check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
. to be filed by the decedent.s representative.
C. 0 The above information is incorrect and/or debts and deductions were paid by you.
You must cOllplliiltB PART 0 and/or PART ~ below.
lIME 1. Data Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please stat. your
relationship to decedent:
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line S of Tax Computation)
perjury, I declare that the facts I have reported above are true~ correct and
nowledge and belief.
HOME
WORK
TEL
("717 ) ..t \lS~ ., 7" l'
( )
PHONE NUMBER
ISt;/~J
DA E"
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on inforllation
submitted by the financial institution.
Z. Inheritance tax bBco.es delinquent nine months after the decedent's date of death.
3. A joint account is taxable even though the decedent's na.8 was added as a matter of convenience.
4. Accounts (inclUding those held between husband and wife) which the decedent put in joint na.es within one year prior to
death arB fully taxable as transfers.
5. Accounts established jointly betwesn husband and wife lIore than one year prior to death are not taxable.
6. Accounts held by a dBcedant nin trust forn another or others are taxable fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed~ place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and sub.it them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(For. REV-1548 EX) upon receipt of the return fro. the Register of Wills.
z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative~ place an "X" in block nB" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue~ Bureau of Individual Taxes~ Dept 280601~ Harrisburg~ PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice infor.ation is incorrect and/or deductions are being claiged~ check block "C" and complete Parts 2 and 3
according to the instructions below. Sign two copies and submit the. with your check for the a.ount of tax payable to the Register
of Wills of the county indicated. The PA Department of Revenue will issue an official assess.ent (For. REV-1548 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the account originally was established or titled in the manner existing at date of death.
For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are
taxable fully as transfers. However~ there is an exclusion not to exceed $3~000 per transferee regardless of the value of
the account or the nu.ber of accounts held.
If a double asterisk (..) appears before your first name in the address portion of this notice~ the $3~000 exclusion
already has been deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account including intarest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is deter.ined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
Example: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the name of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) '" .167 X 100
16.77. (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Example: Joint account registered
the decedent.
I DIVIDED BY Z (SURVIVORS) '" .50
in the nage of the decedent and two other persons and established within one year of death by
X 100
507. (TAXABLE FOR EACH SURVIVOR)
4. The ~ount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The a.ount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) fro. the amount subject to tax (line 4).
7. Enter the appropriate tax rate (line 7) as determined below.
P ounger at
death to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is 07..
The lineal class of heirs includes grandparents~ parents~ children~ and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others~ adopted children and step children. "Lineal descendents" includes all children of the
natural parents end their dBscendents~ whether or not they have been adopted by others~ adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in co..on with the decedent~ whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
Date of Death Spouse Lineal Sibling Collat.,..al
07/0l/9~ to 12/31/9~ 3X 6% lSX 157-
01/01/9S to 06/30/00 OX 6X lSX 15X
07/01/00 to present OX 4.5%. 12X lSX
MThe tax rate 1m osed on the not value of transfers from a deceased chIld twenty-one years of age Dr y
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deter.ined as follows:
A. You legally are responsible for pay.ent~ or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being clailled .ust be ite.ized fully in Part 3. If additional space is needed~ USB plain paper 8 1/2" x 11". Proof of
pay.ent may be requested by the PA Depart.ent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WITMER GERALD G
420 LIMESTONE RD
CARLISLE, PA 17013
_____u_ fold
ESTATE INFORMATION: SSN: 194-14-1922
FILE NUMBER: 2105-0450
DECEDENT NAME: WITMER ESTHER P
DATE OF PAYMENT: 05/17/2005
POSTMARK DATE: 05/03/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 12/12/2004
NO. CD 005334
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05109790 I $48.65
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$48.65
REMARKS:
CHECK#3112
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS